What additional recommendations can be made for a 23-year-old male with difficulty gaining weight despite an increased protein diet?

From the Guidelines

For a 23-year-old male struggling to gain weight despite increased protein intake, I recommend implementing a caloric surplus of 300-500 calories above maintenance needs, focusing on nutrient-dense foods, as the most recent and highest quality study suggests that energy density of the diet is important for weight gain 1.

Key Recommendations

• Consume 5-6 smaller meals throughout the day rather than 3 large ones, and include calorie-dense foods like nuts, avocados, olive oil, and full-fat dairy.
• Incorporate complex carbohydrates such as whole grains, potatoes, and rice alongside your protein sources.
• Strength training 3-4 times weekly with emphasis on compound movements (squats, deadlifts, bench press) will stimulate muscle growth.
• Consider liquid calories through smoothies with protein powder, fruits, nut butters, and milk for easier consumption.
• Ensure adequate sleep (7-9 hours) and manage stress, as both affect metabolism and muscle recovery.
• Track your food intake using an app to ensure you're consistently meeting caloric goals.

Rationale

The study by 1 suggests that energy- and protein-dense nutrition may not improve food consumption, decrease malnutrition or, increase weight loss, but a caloric surplus is necessary for weight gain. Additionally, the study by 1 recommends that older individuals exhibit a blunted post-prandial MPS response to amino acid/protein intake when compared with younger individuals, but this may not be directly applicable to a 23-year-old male. However, the study by 1 recommends that total protein intake should not be excessive (average 50 to 100 g/d) and should be reasonably proportional to carbohydrate and fat intake.

Important Considerations

• Weight gain requires a sustained energy surplus, so consistency is key - aim for gradual gains of 0.5-1 pound weekly.
• If these strategies don't yield results after 1-2 months, consult a healthcare provider to rule out underlying medical conditions like hyperthyroidism or malabsorption issues that could be hindering weight gain.
• Ensure that the diet is safely implemented over the long term, providing adequate nutrients and supporting dietary compliance with a healthful eating plan to prevent increases in disease risk 1.

From the Research

Additional Recommendations for Weight Gain

To address the issue of a 23-year-old male having difficulty gaining weight despite an increased protein diet, several factors should be considered:

• Ensuring adequate overall calorie intake is crucial, as protein alone may not be sufficient for weight gain 2, 3.
• The quality and quantity of protein are important determinants of its nutritional value, and consuming high-quality proteins from animal products (e.g., lean meat and milk) is essential for optimal growth and development 4.
• A dietary intake of 1.0,1.3, and 1.6 g protein per kg body weight per day is recommended for individuals with minimal, moderate, and intense physical activity, respectively 4.
• Consuming protein at the level of requirement appears to be sufficient to aid body weight loss and fat loss, but an additional increase of protein intake may be effective to maintain a larger amount of fat-free mass 3.
• Higher-protein diets that contain between 1.2 and 1.6 g protein · kg-1 · d-1 and potentially include meal-specific protein quantities of at least ∼25-30 g protein/meal provide improvements in appetite, body weight management, cardiometabolic risk factors, or all of these health outcomes 5.

Considerations for Protein Intake

When considering protein intake for weight gain, the following points should be taken into account:

• Chronic high protein intake (>2 g per kg BW per day for adults) may result in digestive, renal, and vascular abnormalities and should be avoided 4.
• The source of protein is an important metabolic regulator, with whey protein and plant-based diets exerting favorable effects on the risk of developing obesity, body composition, metabolic parameters, or fat-free mass preservation of obese patients 6.
• Specific amino-acids like branched chain amino acids (BCAA), methionine, tryptophan, and its metabolites, and glutamate can also positively influence parameters and complications of obesity, especially in rodent models, with less studies translating this in humans 6.

Overall Dietary Approach

A comprehensive approach to weight gain should include:

• Ensuring adequate overall calorie intake to support weight gain, in addition to an increased protein diet 2, 3.
• Monitoring and adjusting protein intake based on individual needs and activity levels 4, 5.
• Considering the quality and source of protein, as well as the potential benefits of specific amino-acids, to optimize nutritional value and support weight gain 4, 6.